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Replicating and redesigning ankle-foot orthoses with 3D printing for children with Charcot-Marie-Tooth disease.
Wojciechowski, Elizabeth A; Cheng, Tegan L; Hogan, Sean M; Mudge, Anita J; Balassone, Daniel; Menezes, Manoj P; Little, David G; Dwan, Leanne N; Burns, Joshua.
Afiliación
  • Wojciechowski EA; University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead, Westmead, Australia. Electronic address: elizabeth.wojciechowski@sydney.edu.au.
  • Cheng TL; University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead, Westmead, Australia.
  • Hogan SM; The Children's Hospital at Westmead, Westmead, Australia.
  • Mudge AJ; The Children's Hospital at Westmead, Westmead, Australia.
  • Balassone D; The Children's Hospital at Westmead, Westmead, Australia.
  • Menezes MP; University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead, Westmead, Australia.
  • Little DG; University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead, Westmead, Australia.
  • Dwan LN; University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead, Westmead, Australia.
  • Burns J; University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead, Westmead, Australia.
Gait Posture ; 96: 73-80, 2022 07.
Article en En | MEDLINE | ID: mdl-35597049
BACKGROUND: Children with the most common inherited neuropathy, Charcot-Marie-Tooth disease (CMT), are often prescribed ankle-foot orthoses (AFOs) to improve walking ability and prevent falls by reducing foot drop, postural instability, and other gait impairments. These externally worn assistive devices are traditionally custom-made using thermoplastic vacuum forming. This labour-intensive manufacturing process often results in AFOs which are cumbersome due to limited design options, and are associated with low acceptability, discomfort, and suboptimal impact on gait. The aim of this study was to determine how 3D printing can be used to replicate and redesign AFOs in children with CMT. METHODS: Traditional AFOs, 3D printed replica AFOs (same design as traditional AFOs), 3D printed redesigned AFOs and a shoes only control condition were compared in 12 children with CMT. 3D printed AFOs were manufactured using material extrusion in Nylon-12. 3D gait analysis (temporal-spatial, kinematic, kinetic), in-shoe pedobarography and self-reported satisfaction were used to compare conditions. The primary kinematic and kinetic outcome measures were maximum ankle dorsiflexion in swing and maximum ankle dorsiflexor moment in loading response, to capture foot drop and an absent of heel rocker. RESULTS: The 3D printed replica AFOs were comparable to traditional AFOs for all outcomes. The 3D printed replica AFOs improved foot position at initial contact and during loading response and significantly reduced pressure beneath the whole foot, rearfoot and forefoot compared to the shoes only. The 3D printed redesigned AFOs produced a device that was significantly lighter (mean -35.2, SD 13.3%), and normalised maximum ankle dorsiflexor moment in loading response compared to shoes only and traditional AFOs. SIGNIFICANCE: 3D printing can be used to replicate traditional handmade AFOs and to redesign AFOs to produce a lighter device with improved biomechanics by incorporating novel design features.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Enfermedad de Charcot-Marie-Tooth / Neuropatías Peroneas / Ortesis del Pié Límite: Child / Humans Idioma: En Revista: Gait Posture Asunto de la revista: ORTOPEDIA Año: 2022 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Enfermedad de Charcot-Marie-Tooth / Neuropatías Peroneas / Ortesis del Pié Límite: Child / Humans Idioma: En Revista: Gait Posture Asunto de la revista: ORTOPEDIA Año: 2022 Tipo del documento: Article